What is it about?
A 79-year-old man presented to a chiropractor with a two-year history of gradual-onset chin-on-chest posture and increased thoracic kyphosis, which had failed to respond to physical therapy. The chiropractor ordered whole spine computed tomography which revealed extensive mixed lytic and sclerotic changes and multiple thoracic compression fractures suggestive of metastasis. The chiropractor promptly referred the patient to an oncologist, who performed a biopsy confirming prostate adenocarcinoma. The patient’s health deteriorated, and he expired three weeks later.
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Why is it important?
Dropped head syndrome is a rare disorder involving an inability to hold the head upright. It may be caused by a variety of neuromuscular disorders and occasionally by pathological vertebral fractures.
Perspectives
This case highlights that chiropractors should be aware that patients may present to their office with symptoms related to undiagnosed cancer, such as spinal deformity and dropped head syndrome. Chiropractors should order advanced imaging when patients have red flag signs or symptoms (e.g., older age, progressive symptoms despite care) and refer to an oncologist when clinical features or testing are suggestive of metastasis.
Dr Eric Chun-Pu Chu 朱君璞
New York Medical Group
Read the Original
This page is a summary of: Spinal Metastasis Causing Dropped Head Syndrome in the Chiropractic Office: A Case Report, Cureus, February 2023, Cureus, Inc.,
DOI: 10.7759/cureus.34796.
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